Resting motor threshold in the course of hand motor recovery after stroke: a systematic review.
J Neuroeng Rehabil
; 18(1): 158, 2021 11 03.
Article
en En
| MEDLINE
| ID: mdl-34732203
ABSTRACT
BACKGROUND:
Resting motor threshold is an objective measure of cortical excitability. Numerous studies indicate that the success of motor recovery after stroke is significantly determined by the direction and extent of cortical excitability changes. A better understanding of this topic (particularly with regard to the level of motor impairment and the contribution of either cortical hemisphere) may contribute to the development of effective therapeutical strategies in this cohort.OBJECTIVES:
This systematic review collects and analyses the available evidence on resting motor threshold and hand motor recovery in stroke patients.METHODS:
PubMed was searched from its inception through to 31/10/2020 on studies investigating resting motor threshold of the affected and/or the non-affected hemisphere and motor function of the affected hand in stroke cohorts.RESULTS:
Overall, 92 appropriate studies (including 1978 stroke patients and 377 healthy controls) were identified. The analysis of the data indicates that severe hand impairment is associated with suppressed cortical excitability within both hemispheres and with great between-hemispheric imbalance of cortical excitability. Favorable motor recovery is associated with an increase of ipsilesional motor cortex excitability and reduction of between-hemispheric imbalance. The direction of change of contralesional motor cortex excitability depends on the amount of hand motor impairment. Severely disabled patients show an increase of contralesional motor cortex excitability during motor recovery. In contrast, recovery of moderate to mild hand motor impairment is associated with a decrease of contralesional motor cortex excitability.CONCLUSIONS:
This data encourages a differential use of rehabilitation strategies to modulate cortical excitability. Facilitation of the ipsilesional hemisphere may support recovery in general, whereas facilitation and inhibition of the contralesional hemisphere may enhance recovery in severe and less severely impaired patients, respectively.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Accidente Cerebrovascular
/
Rehabilitación de Accidente Cerebrovascular
/
Corteza Motora
Tipo de estudio:
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
J Neuroeng Rehabil
Asunto de la revista:
ENGENHARIA BIOMEDICA
/
NEUROLOGIA
/
REABILITACAO
Año:
2021
Tipo del documento:
Article
País de afiliación:
Alemania